Hypothesis: Young children can learn safety behavior in the public school system. These children will modify family seat belt use. SETTING DESIGN: This is a prospective cohort analytic study conducted in a 50,000 square mile regionalized trauma center referral area.
Methods: A school-based injury prevention program targeting kindergarten through second-grade (K-2) students addressed four aspects of traffic safety: seat belt use, pedestrian and bicycle safety, school bus safety, and unsafe rides. After inservice instruction, teachers taught the program over a 10-week period. A simultaneous community traffic safety program was conducted through the media. Family seat belt use was monitored by blinded observation at six study schools and one control school. Income level of schools was characterized as low or high, based on student use of federal lunch subsidies. School program implementation was defined as good or poor, based on adherence to teaching protocol.
Results: A total of 68,650 K-2 students have completed this traffic safety program during 1990 to 1994. During the study year (1992 to 1993), 25,900 students completed the program taught by 1,400 teachers in 95 schools. A total of 5,936 observations of seat belt use were made in seven schools. Income stratification delineated a subset of these schools in which seat belt use increased by 86% (p = 0.01). Half of the schools failed to follow protocol, and no change in seat belt use was observed.
Conclusions: (1) School K-2 safety education improves family seat belt use, (2) low income schools should be targeted, and (3) strict adherence to the teaching protocol is essential.